Annekathryn Goodman, MD, FACS

This article focuses on the recent debate regarding when-or whether-patients with ovarian cancer should undergo aggressive surgical resection.

Tumor resection without expectationof complete excision violatesthe traditional tenets ofsurgical oncology. The concept of operabilitycarries the implication ofcomplete tumor excision with a marginof normal tissue. This classic viewwas challenged by Griffith’s landmark1975 paper showing an improved survivalwith surgical cytoreduction-atechnique that cut across tumor andrarely attained negative margins.[1] Heshowed in 70 patients that survival timewas inversely proportional to the sizeof the residual tumor after surgery.